CN104135957B - surgical device - Google Patents

surgical device Download PDF

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Publication number
CN104135957B
CN104135957B CN201380010521.9A CN201380010521A CN104135957B CN 104135957 B CN104135957 B CN 104135957B CN 201380010521 A CN201380010521 A CN 201380010521A CN 104135957 B CN104135957 B CN 104135957B
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CN
China
Prior art keywords
above
mentioned
high frequency
output
time
Prior art date
Application number
CN201380010521.9A
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Chinese (zh)
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CN104135957A (en
Inventor
佐内秀男
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奥林巴斯株式会社
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Priority to US201261636269P priority Critical
Priority to US61/636269 priority
Application filed by 奥林巴斯株式会社 filed Critical 奥林巴斯株式会社
Priority to PCT/JP2013/060447 priority patent/WO2013157408A1/en
Publication of CN104135957A publication Critical patent/CN104135957A/en
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Publication of CN104135957B publication Critical patent/CN104135957B/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00022Sensing or detecting at the treatment site
    • A61B2017/00026Conductivity or impedance, e.g. of tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/320068Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • A61B2017/320094Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing clamping operation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00875Resistance or impedance
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/002Irrigation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/007Aspiration

Abstract

A surgical device (1) has: a treatment unit (31) for treating a biological tissue; a high-frequency output unit (44) for imparting a high-frequency current to the treatment unit (31); a fluid-conveying tube (25) for conveying a fluid; an aspiration tube (26) for aspirating the fluid; a first pump (47) for supplying the fluid to the fluid-conveying tube (25), in order to convey the fluid from a fluid-conveying port positioned in the treatment unit (31); a second pump (49) for aspirating the fluid via the aspiration tube (26) from an aspiration port provided in the treatment unit (31); and a CPU (41). The CPU (41) controls the second pump (49) in conjunction with the stoppage of output of the high-frequency current from the high-frequency output unit (44), and in a manner such that the fluid is aspirated via the second pump (49) for only a prescribed interval of time after the stoppage of output of the high-frequency current.

Description

Operation device

Technical field

The present invention relates to a kind of operation device, more particularly to a kind of operation device that can carry out high frequency electric output.

Background technology

Surgery treatment apparatus are disposed used in operation in solidification, incision for carrying out bio-tissue etc..Surgery use Put utensil to there is grasp body tissue or make the type that surgery contacts to be disposed with treatment apparatus with bio-tissue Treatment apparatus (so-called shears shape or blade geometry type).In addition, in surgery use puts utensil a kind of for example known energy Enough carry out the high-frequency treatment utensil of high frequency electric output.For example known one kind can carry out ultrasound wave in surgery use puts utensil Ultrasonic treatment apparatus and the high-frequency treatment utensil of high frequency electric output can be carried out that vibration is exported, also, go back in recent years A kind of known energy treatment apparatus that can simultaneously carry out ultrasonic activation output and high frequency electric output.

In the ultrasonic treatment apparatus of shears shape type, the part of side carries out ultrasonic activation, the jaw of opposite side Part is opened and closed to be clamped relative to the part of side.In addition, in the high-frequency treatment utensil of shears shape type, using Two parts are carrying out the bipolar output of high frequency electric.

Sometimes using this treatment apparatus normal saline solution is dripped while carrying out based on the disposal of high frequency output.For example Stopped blooding to be directed to hepatic parenchymal oozing of blood, i.e., in order that the stopped bleeding oozed out on a large scale, while the normal saline solution that drips While carrying out high frequency output.With normal saline solution soak oozing of blood scope in the state of apply high frequency output, thus, it is possible to It is interior on a large scale to carry out being disposed for the hemostasis of oozing of blood.When the disposal for hemostasis is carried out for this oozing of blood, normal saline solution Hydrops are produced in vivo, therefore assistant attracts the normal saline solution of accumulation using suction catheter.

In addition, in United States Patent Publication US2010/137751A1 description, United States Patent Publication Disclose in US2003/0040672A1 description and United States Patent Publication US2010/0324458A1 description It is a kind of to provide liquid to treatment apparatus in disposal process and attract the operation device of liquid.

But, surgeon cannot be disposed during assistant attracts liquid, and suction catheter blocks surgeon's The visual field, therefore cannot also observe the state for confirming disposal portion.

Do not account in any one of above-mentioned United States Patent Publication for oozing of blood hemostasis dispose etc. in this The problem of sample.

Present invention is completed in view of the above problems, it is therefore intended that provide a kind of disposal for oozing of blood etc. In the operation device of liquid that appropriately and rapidly can accumulate in attractor in the energy end of output of high frequency electric.

The content of the invention

A mode of the invention, operation device has:Disposal portion, it is used to dispose bio-tissue;Can volume production Life portion, it produces the energy for providing above-mentioned disposal portion high frequency electric;Liquor charging pipeline, it is used to send liquid;Suction catheter Road, it is used to attract aforesaid liquid;Liquor charging mouth, it is arranged at above-mentioned disposal portion, for sending from above-mentioned liquor charging pipeline Aforesaid liquid;Suction port, it is arranged at above-mentioned disposal portion, for aforesaid liquid to be attracted in above-mentioned suction pipeline;First Pump, it is used to aforesaid liquid is provided to above-mentioned liquor charging pipeline to send aforesaid liquid from above-mentioned liquor charging mouth;Second pump, it is used for Attract aforesaid liquid from above-mentioned suction port via above-mentioned suction pipeline;And control unit, its with from above-mentioned energy production portion The output of above-mentioned energy stops linkedly controlling above-mentioned second pump so that after the output of above-mentioned energy stops, by above-mentioned Second pump is come the time for attracting aforesaid liquid to specify or the amount of regulation.

Description of the drawings

Fig. 1 is the figure for illustrating the structure of the operation device involved by the first embodiment of the present invention.

Fig. 2 is power subsystem 12 involved by the first embodiment for representing the present invention, liquor charging unit 13 and attracts single The block diagram of the structure of unit 14.

Fig. 3 be the high frequency output time To that stored of storage part 42 involved by the first embodiment for representing the present invention with The figure of the relation of pull up time Ts.

Fig. 4 is carrying out to HF output sections 44 and pump drive division 46,48 involved by the first embodiment for representing the present invention The flow chart of the example of the process of the CPU 41 of control.

Fig. 5 is carrying out to HF output sections 44 and pump drive division 46,48 involved by the first embodiment for representing the present invention The flow chart of the example of the process of the CPU 41 of control.

Fig. 6 be the present invention first embodiment involved by output signal EOUT for carrying out high frequency electric output and The sequential chart of pump drive signal PiOUT, PsOUT of pump 47,49.

Fig. 7 is the figure for illustrating the structure of the operation device 1A involved by second embodiment of the present invention.

Fig. 8 is to represent carrying out to HF output sections 44 and pump drive division 46,48 involved by second embodiment of the present invention The flow chart of the example of the process of the CPU 41 of control.

Fig. 9 is to represent carrying out to HF output sections 44 and pump drive division 46,48 involved by second embodiment of the present invention The flow chart of the example of the process of the CPU 41 of control.

Figure 10 be output signal EOUT for carrying out high frequency electric output involved by second embodiment of the present invention, The pump drive signal PiOUT of pump 47, the pump drive signal PsOUT of pump 49, the sequential for attracting normal saline solution from peristome 21c Figure.

Specific embodiment

Below, with the embodiment explanation present invention.

(first embodiment)

Fig. 1 is the figure for illustrating the structure of the operation device involved by the first embodiment of the present invention.Such as Fig. 1 institutes Show, operation device 1 is configured to include treatment apparatus 11, power subsystem 12, liquor charging unit 13 and attraction unit 14.

Treatment apparatus 11 are the scissor for being capable of at least one of output ultrasonic wave vibrational energy and high frequency electric energy The surgery treatment apparatus of shape type.Treatment apparatus 11 are configured to disposal unit 21, handle unit 22, oscillator unit 23, letter Number cable 24 and liquid pushing tube 25.

Disposal unit 21 by for dispose bio-tissue disposal portion 31 and elongated sheath section 32 constitute.Disposal portion 31 have the probe 31a and movable member 31b as jaw members.Sheath section 32 be cartridge, probe 31a, movable part Axle portion part for opening and closing of part 31b etc. is through the inside of the sheath section 32.Movable member 31b can with to handle list Unit 22 operated caused by axle portion part etc. movement correspondingly, in being arranged at the pin 32a of the front end of sheath section 32 as axle The heart and rotate.Therefore, the leading section of probe 31a constitutes the clamping part for grasp body tissue with movable member 31b.

Also, the leading section of disposal unit 21 is provided with the peristome 21a for sending normal saline solution, peristome 21a is connected with the pipe 21b in sheath section 32.As shown in the dotted arrow a of Fig. 1, peristome 21a and pipe 21b is configured with, So that sending normal saline solution towards the retained part between the probe 31a and movable member 31b in disposal portion 31 and can drip Normal saline solution.Thus, peristome 21a is arranged at disposal portion 31, is for using from the life of the pipe 21b as liquor charging pipeline Reason saline solution passes out to the liquor charging mouth between bio-tissue and disposal portion 31.

The base end part for also extending through the pipe 21b in handle unit 22 is connected with liquid pushing tube 25, and liquid pushing tube 25 connects with pipe 21b It is logical.As described subsequently, treatment apparatus 11 are configured to make the normal saline solution as the liquid sent from liquor charging unit 13 Projected from peristome 21a by liquid pushing tube 25 and pipe 21b.Therefore, liquid pushing tube 25 is constituted for sending physiological saline with pipe 21b The liquor charging pipeline of water.

In addition, being provided with the peristome 21c for attracting normal saline solution, peristome in the leading section of disposal unit 21 21c be connected through the pipe 21d in sheath section 32.Also extend through the base end part of the pipe 21d in handle unit 22 and attract Pipe 26 is connected, and suction catheter 26 is connected with pipe 21d.As described subsequently, treatment apparatus 11 are configured to by attracting unit 14 attract normal saline solution via suction catheter 26 and pipe 21d from peristome 21c.Therefore, suction catheter 26 and pipe 21d are constituted for inhaling Draw the suction pipeline of normal saline solution.

And, peristome 21a is arranged at disposal portion 31, is the life for sending from the pipe 21b as liquor charging pipeline The liquor charging mouth of reason saline solution.Peristome 21c is arranged at disposal portion 31, is for normal saline solution to be attracted to as suction catheter Suction port in the pipe 21d on road.

Handle unit 22 has rotary knob 35 in the front of the main part 34 of tubular.Surgeon is by around main part 34 Axle rotate rotary knob 35 can change disposal portion 31 probe 31a direction.

Oscillator unit 23 is installed in the base end part of main part 34.Oscillator unit 23 is connected with probe 31a.Oscillator unit 23 inside has ultrasonic oscillator (not shown), and probe 31a can be made to carry out ultrasonic activation.

Main part 34 has handle portion 36, and handle portion 36 includes fixed handle 36a and can fixed handle 36b.Handle portion 36 is For the operation handle of grasp body tissue.Surgeon when carry out operation cause can the close fixed handle 36a of fixed handle 36b, When closing handle portion 36, the movable member 31b for making disposal portion 31 is rotated, and can be pressed from both sides between probe 31a and movable member 31b Hold bio-tissue.

Also, main part 34 is provided with the multiple switch 37 of output function.Therefore, surgeon can be while hold handss The one side of shank 36 is operated, in the leading section by the probe 31a in disposal portion 31 and movable member 31b grasp body tissues In the state of, by switch 37 carry out making operation carry out based on ultrasonic activation output, based on high frequency electric output or The disposal exported while person is based on ultrasonic activation and high frequency electric.

Power subsystem 12 is control device, as described subsequently, comprising control unit, switch 37 is carried out according to surgeon Operation, is controlled to ultrasonic activation output and high frequency electric output, liquor charging and attraction.

Liquor charging unit 13 is connected by signal cable 13a with power subsystem 12.In addition, liquor charging unit 13 is used by liquor charging Liquid pushing tube 25 be connected with treatment apparatus 11, normal saline solution can be sent to treatment apparatus 11 from liquor charging unit 13.

Unit 14 is attracted to be connected with power subsystem 12 by signal cable 14a.In addition, attracting unit 14 to use by attracting Suction catheter 26 be connected with treatment apparatus 11, by attract unit 14 can from peristome 21c attract normal saline solution.

Fig. 2 is the block diagram of the structure for representing power subsystem 12, liquor charging unit 13 and attracting unit 14.Power subsystem 12 is The control device that energy output to treatment apparatus 11 is controlled.Power subsystem 12 includes the operating surface as operating and setting portion Plate 40, as central processor (hereinafter referred to as CPU) 41, storage part 42, ultrasound wave output section (the hereinafter referred to as US of control unit Output section) 43, high frequency output portion (hereinafter referred to as HF output sections) 44 and impedance detection section 45, wherein, above-mentioned ultrasound wave output Portion exports the drive signal of the drive vibrator unit 23 for ultrasonic activation output, and above-mentioned high frequency output portion is exported for high frequency The high-frequency current signal of electric current output.

As described above, CPU 41 is exported to ultrasonic activation, high frequency electric is exported or ultrasonic activation and high frequency electric While output be controlled.The control is carried out by performing control program that storage part 42 stored by CPU 41.

Storage part 42 is comprising for storing the ROM of the control program, as the RAM and use in working area during configuration processor In rewritable nonvolatile memory of information for storing the liquor charging time described later etc..

US output sections 43 will be used to make probe 31a carry out ultrasound according to the ultrasound wave output control signal from CPU 41 The drive signal of ripple vibration is via the output of signal cable 24 to treatment apparatus 11.

HF output sections 44 will be used to provide bipolar to disposal portion 31 according to the high frequency output control signal from CPU 41 The high-frequency current signal of high frequency output is via the output of signal cable 24 to treatment apparatus 11.

Therefore, US output sections 43 and HF output sections 44 are respectively energy production portion, produce for applying super to disposal portion 31 Acoustic vibration and the energy of high frequency electric.

Impedance detection section 45 is for the impedance to the bio-tissue being clamped between probe 31a and movable member 31b The circuit for being detected.That is, in 45 pairs of disposal portions 31 of impedance detection section be used for grasp body tissue two hold assemblies it Between impedance detected.Impedance detection section 45 is by detection signal corresponding with the impedance between probe 31a and movable member 31b It is supplied to CPU 41.

In addition, being also input into the operation signal from switch 37 to CPU 41.Additionally, here, as described in below Can also be opened by foot-operated by the instruction of the instruction that energy output is carried out by surgeon's Operation switch 37, but energy output Close etc. come carry out.

Liquor charging unit 13 includes pump drive division 46 and pump 47.According to pump drive division 46 via signal cable 13a from The pump drive signal of CPU 41 is exporting the drive circuit of the drive signal for transfer tube 47.As the first pump pump 47 with not The container of diagram is connected, and is driven according to the drive signal from pump drive division 46, by storage physiological saline in a reservoir Water extraction supply pipe 25.The discharge ability of pump 47 is, for example, 20ml/min.That is, pump 47 is following pump:For by physiological saline water extraction Supply liquor charging pipeline causes from the peristome 21a as liquor charging mouth to send the liquid of normal saline solution.

Attract unit 14 comprising pump drive division 48 and pump 49.According to pump drive division 48 via signal cable 14a from The pump drive signal of CPU 41 is exporting the drive circuit of the drive signal for transfer tube 49.As the second pump pump 49 with not The container of diagram is connected, and is driven according to the drive signal from pump drive division 48, the physiological saline that will attract via pipe 26 Water is discharged to container (not shown).The attraction power of pump 49 is, for example, 20ml/min.That is, pump 49 is following pump:For via suction Skirt road attracts the liquid of normal saline solution from the peristome 21c as suction port.

CPU 41 controls US output sections 43 and HF output sections 44, and controlling pump according to the operation signal from switch 37 Drive division 46 and 48.

Preset and be stored with the pull up time of the normal saline solution attracted by pump described later 49 in storage part 42 Data.

Fig. 3 is the figure of the relation for representing high frequency output time To and pull up time Ts being stored in storage part 42.High frequency Output is to interlock with the driving of liquid-feeding pump 47, therefore pull up time Ts has proportionate relationship relative to high frequency output time To. Thus, to become greatly with high frequency output time To and the elongated mode of pull up time Ts, storage is preset in storage part 42 There is pull up time Ts for high frequency output time To.Pull up time Ts corresponding with high frequency output time To is for example with table data Form be stored in storage part 42.As described subsequently, high frequency output time To is equal with the driving time of pump 47.

Additionally, for pull up time Ts corresponding with high frequency output time To, according to ability of the pump 47 from 49 be different, operation The hope of teacher, can carry out setting change by surgeon Dengs in the guidance panel 40 of power subsystem 12.

That is, pull up time Ts is set to make the normal saline solution sent in the disposal using energy be attracted and become Time needed for state without normal saline solution.

Additionally, in figure 3, pull up time Ts is set to linearly increase in ratio relative to high frequency output time To, But can also increase with being set as step as shown in a chain-dotted line.

Fig. 4 and Fig. 5 are the examples of the process for representing the CPU 41 being controlled to HF output sections 44 and pump drive division 46,48 Flow chart.Fig. 6 be output signal EOUT for carrying out high frequency electric output and pump 47,49 pump drive signal PiOUT, The sequential chart of PsOUT.

The process of Fig. 4 is being switched when 37 energy for being pressed and connecting so as to indicate high frequency electric are exported by CPU 41 The process of execution.

When switching 37 and being pressed and receive the instruction of energy output, CPU 41 carries out the indicated energy output (S1).In the case where energy is output as high frequency electric output, with regulation or indicated output driving HF output section 44. While carrying out energy output, CPU 41 exports pump drive signal PiOUT to pump drive division 46 to drive the pump 47 of liquor charging (S2).In figure 6, output signal EOUT becomes HIGH (height) in moment t1, proceeds by energy output and liquor charging.

CPU 41 also is carrying out having started with the timing of software counter etc. while energy is exported, to high frequency electric Output time is measured (S3).

Then, CPU 41 judges whether switch 37 is disconnected, i.e. whether the output of enable amount stops (S4), defeated in the amount of being not enabled on Go out (S4 when stopping:"No"), process returns to S1.(the S4 when energy output is stopped:"Yes"), CPU 41 stops output time Measurement (S5), stop output pump drive signal PiOUT to stop the pump 47 (S6) of liquor charging.

Then, CPU 41 calculates energy output according to the count value of the enumerator of the measurement for being used to carry out output time Output time, pull up time Ts (S7) being stored in storage part 42 is read according to the output time To for calculating.Example Such as, in figure 3, when output between To be to1 when, read pull up time Ts value ts1.

, by pump drive signal PsOUT outputs to pump drive division 48, transfer tube 49 is being attracted (S8) for CPU 41.Its knot Really, the peristome 21c from the leading section of the sheath section 32 for the treatment of apparatus 11 attracts to convey accumulation to carry out the hemostasis of oozing of blood Normal saline solution.In figure 6, in moment t2, the driving of the pump 47 of energy output and liquor charging stops and proceeds by attraction.

In addition it is also possible to the pump 49 of attraction is driven after the stipulated time after energy exports stopping.For example Can energy output stop after after the time of the degree that surgeon will not feel pressure transfer tube 49.Surgeon The time of the degree that will not be felt pressure is, for example, the time delay of 0.5 second.

CPU 41 also starts with different from the enumerator for being used to carry out timing to output time while starting and attracting Software counter etc. carry out timing, pull up time Ts is measured (S9).

When being attracted, CPU 41 judges whether that switch 37 has been carried out operation and indicated beginning energy output (S10).(the S10 when starting energy and exporting:"Yes"), CPU 41 stops exporting pump drive signal PsOUT to pump drive division 48, stops Only pump 49 come stop attract (S11), process return to S1.That is, CPU 41 is received to making after stopping in the output of energy For energy production portion HF output sections 44 energy production indicate when, stop pump 49, preferentially carry out the operation instruction of surgeon.

Do not starting (S10 when energy is exported:"No"), judge whether the elapsed time from starting to attract have passed through reading Pull up time Ts (S12).CPU 41 judges whether the time from starting to attract have passed through pull up time Ts of reading.From Start elapsed time for having attracted no (S12 when pull up time Ts read from storage part 42:"No"), process is returned to S8, proceeds to attract.

(the S12 when the elapsed time from starting to attract is through pull up time Ts:"Yes"), CPU 41 stops being driven to pump Portion 48 exports pump drive signal PsOUT, stops attracting (S13), removes based on locking two of output time with pull up time Number device (S14).In figure 6, stop attracting in moment t3.

That is, the CPU 41 as control unit stops with the output of the energy from the HF output sections 44 as energy production portion Linkedly, the controlling pump 49 after the output of energy stops so that the time specified by the attraction normal saline solution of pump 49.Specifically Say that CPU 41 stops correspondingly starting transfer tube 49 to attract normal saline solution defeated with energy by pump 49 with the output of energy in ground Go out time or liquor charging time corresponding pull up time, and after the time for attracting normal saline solution to specify by pump 49, enter Row control stops pump 49.

As a result, setting pull up time Ts during attracted, therefore when will be disposed using energy conveying and The normal saline solution of accumulation attracts the amount accumulated.That is, surgeon can not attract due to for the hemostasis of oozing of blood by assistant Dispose and accumulate normal saline solution in vivo, therefore do not need assistant and there is not yet the suction catheter of assistant's operation to the visual field Hinder ground remove accumulate normal saline solution, surgeon can promptly proceed operation.

As described above, according to the operation device 1 of above-mentioned present embodiment, in the case where disposal to oozing of blood etc. is carried out, The normal saline solution for accumulating in vivo is promptly removed, therefore surgeon can promptly proceed operation.As a result, closing It is tied to the shortening of operating time.

(second embodiment)

In the above-described first embodiment, with energy output stopping linkedly, the transfer tubes 49 of CPU 41 and start attract, But in this second embodiment, according to the clipping operation of handle portion 36, mechanically press suction catheter 26 or suction catheter 21d proceeds by attraction when the clipping operation is released from limiting attraction.

Fig. 7 is the figure for illustrating the structure of the operation device 1A involved by present embodiment.In the figure 7, pair with Fig. 1 phases With the additional identical reference of structural element and omit the description.Here, when the instruction of energy output has been carried out, to close Mode manipulator shank 36A.

In operation device 1A, treatment apparatus 11A can fixed handle 36b1 there is jut 51, when handle portion 36A is closed When closing, the jut 51 is contacted with suction catheter 21d and deforms suction catheter 21d.In addition, fixation sets in fixed handle 36a Receiving part 52 is equipped with, the receiving part 52 receives the suction catheter 21d deformed due to jut 51.

That is, when handle portion 36A is closed and can fixed handle 36b1 along Fig. 7 with shown in solid arrow b direction move when, Suction catheter 21d is mechanically pressed into receiving part 52 by jut 51 in fixed handle 36a, deforms suction catheter 21d To stop the attraction from pump 49 using suction catheter 21d.When surgeon opens handle portion 36A, suction catheter 21d is not received from prominent The power in portion 51 is played, normal saline solution is flow through in suction catheter 21d.

Therefore, the jut 51 and receiving part 52 in handle portion 36A is configured between the two ends of suction catheter 21d, structure Into liquid attract limiting mechanism, according to as operation handle can fixed handle 36b1 operation come in suction catheter 21d limit The flowing of the liquid being attracted.

The structure of power subsystem 12, liquor charging unit 13 and attraction unit 14 is identical with the structure shown in Fig. 2.CPU's 41 The content of process is different from the process of first embodiment.

Fig. 8 and Fig. 9 are the examples of the process for representing the CPU 41 being controlled to HF output sections 44 and pump drive division 46,48 Flow chart.In figs. 8 and 9, pair with the additional identical reference of Fig. 4 and Fig. 5 identicals process and simply say It is bright.Processing sequence of Fig. 8 and Fig. 9 etc. is different from Fig. 4 and Fig. 5.Figure 10 is the output signal for carrying out high frequency electric output EOUT, the pump drive signal PiOUT of pump 47, the pump drive signal PsOUT of pump 49 and from peristome 21c attract normal saline solution Sequential chart.

In fig. 8, when switching 37 and being pressed and receive the instruction of energy output, CPU 41 carries out the indicated energy Output (S1), then, by drive signal output to pump drive division 46, transfer tube 47 is carrying out liquor charging (S2).Then, CPU 41 to Pump drive division 48 exports pump drive signal PsOUT, and transfer tube 49 is being attracted (S8).

When the instruction of energy output is carried out, handle portion 36A is closed, therefore jut 51 deforms liquid pushing tube 21d.Cause This, even if pump 49 is driven also not carrying out using the attraction of pump 49.In Fig. 10, output signal EOUT moment t11 start into Row output, but do not attract normal saline solution.

After S8, CPU 41 proceeds by the measurement (S3) of output time, next, it is determined that whether stopped energy output (S4)。

Do not indicating to stop (S4 when energy is exported:"No"), process returns to S1.It is not pressed in switch 37 and indicates Stop (S4 when energy is exported:"Yes"), CPU 41 stops the measurement (S5) of output time, stops the pump 47 (S6) of liquor charging, reads Go out pull up time Ts (S7) being stored in storage part 42 corresponding with the output time for measuring.

When with energy output and surgeon's opening handle portion 36A is stopped, jut 51 becomes not press suction catheter 21d, therefore proceed by attraction.As a result, attracting life from the peristome 21c of the leading section of the sheath section 32 for the treatment of apparatus 11A Reason saline solution.In Fig. 10, in moment t12, stop energy and export and proceed by attraction.

CPU 41 starts the measurement (S9) of pull up time after energy output is stopped.CPU 41 judges whether inhaled Operation switch 37 when drawing and indicate beginning energy output (S10), when start energy export when (S10:"Yes"), handle portion 36A It is closed and processes and return to S1.This is because, also in the same manner as first embodiment, the operation for preferentially carrying out surgeon refers to Show.

(S10 when energy is exported is not being started to:"No"), judge whether the time from energy output is stopped have passed through reading Pull up time Ts (S12) for the going out, (S12 when the elapsed time from starting to attract is without pull up time Ts:"No"), process S9 is returned to, proceeds to attract.

(the S12 when the elapsed time from starting to attract is through pull up time Ts:"Yes"), CPU 41 is not to pump drive division 48 output pump drive signal PsOUT, stop attracting (S13), and end is processed.In Fig. 10, stop attracting in moment t13.

Therefore, by present embodiment, also attracted during the liquor charging time Ts of setting, therefore, it is possible to defeated in energy Attract to accumulate normal saline solution in vivo due to the disposal for oozing of blood after going out.

As described above, according to the operation device 1A of above-mentioned present embodiment, in the situation for carrying out the disposal for oozing of blood etc. Under, attract to accumulate normal saline solution in vivo, therefore do not need assistant and there is not yet the suction catheter of assistant's operation to regarding The wild ground that hinders removes the normal saline solution for accumulating, and surgeon can promptly proceed operation.

Additionally, in the above example, the operation of switch 37 and the on-off action of handle portion 36A for energy output is only It is vertical, but can also arrange in handle portion 36A and switch, when by handle portion 36A can fixed handle 36b1 operation closing During switch, switch connection and produce energy output indication signal.For example in the figure 7, as described in parantheses, can start Handle 36b1 is provided with the juts 53 different from jut 51, is provided with fixed handle 36a and is dashed forward when handle portion 36A is closed Play the switch 54 that portion 53 presses.

According to this structure, the operation of switch and the on-off action of handle portion 36A that can be used in energy output is interlocked.

As described above, according to the operation device of the respective embodiments described above, in the case where disposal for oozing of blood etc. is carried out, The normal saline solution for accumulating in vivo is promptly removed, therefore surgeon can promptly proceed operation.

The operation device of the respective embodiments described above is especially effective in disposing for hepatic parenchymal energy.It is being enclosed in film It is hepatic parenchymal in the case of, easily produce oozing of blood.In this case, according to the operation device of the respective embodiments described above, with Normal saline solution is promptly removed after the energy end of output being disposed, therefore surgeon can promptly proceed Operation.

Additionally, the operation device of each embodiment can not only be applied to liver parenchyma, additionally it is possible to be applied to blood vessel etc. other Internal organs etc., and be effective.

(variation 1)

In above-mentioned two embodiment, after energy end of output, professional etiquette will be drawn into and fixed time, but be that instead of rule Fixing time, it is quantitative will to be drawn into professional etiquette.That is, CPU 41 can also controlling pump 49 with attract with energy dispose when output When output time or liquor charging time corresponding ormal weight liquid.

In this case, it is stipulated that amount is that the information of traffic attraction is stored in storage part 42, and two embodiment party as described above Formula like that, is set as according to measuring the output time that obtains or the liquor charging time is different and different.Also, surgeon can be to this The value of the liquor charging amount that storage part 42 is stored carries out setting change.

(variation 2)

In above-mentioned two embodiment and above-mentioned variation 1, when pull up time or traffic attraction are to be exported according to energy Between either the liquor charging time and be pre-set in the pull up time or traffic attraction of storage part 42, it is also possible to according to by impedance detection section The resistance value of 45 bio-tissues being clamped between probe 31a and movable member 31b for detecting is changing pull up time etc. Attraction pattern.

(variation 3)

In above-mentioned two embodiment and above-mentioned variation 1, when pull up time or traffic attraction are to be exported according to energy Between either the liquor charging time and be pre-set in the pull up time or traffic attraction of storage part 42, but can also be surgeon in behaviour Make to set pull up time or traffic attraction in panel 40, no matter how energy output time or liquor charging time attract set The pull up time or traffic attraction.

Therefore, CPU 41 after energy end of output controlling pump 49 attracting the set pull up time or attraction Amount.

(variation 4)

In above-mentioned two embodiment and each variation, liquid pushing tube 21b and suction catheter 21d are respectively set at disposer In tool 11,11A, but the diameter that there are problems that sheath section 32 when pipe is arranged in sheath section 32 becomes big this.Therefore, also may be used With by least one of liquid pushing tube 21b and suction catheter 21d with the space or interior between the inner tube and outer tube in sheath section 32 Space between pipe and probe 31a is replacing.

In this case, the respective inner side and outer side of each inner tube and outer tube is applied with insulant.This is in order to that is, Normal saline solution is present between inner tube and outer tube or inner tube and probe 31a between also do not produce and conduct.

For example in the case where making normal saline solution flow through the outside of probe 31a, it is prevented between probe 31a and inner tube Electrical short.Also, in the case where making normal saline solution flow through between inner tube and outer tube, it is prevented from electricity between inner tube and outer tube Short circuit.

For the coating of inner tube and the insulant of the inner side of outer tube, the spray of injecting type can be inserted in the inner side of each pipe Mouth, by making nozzle mobile while carrying out from nozzle injection insulant inside pipe.

According to this structure, the diameter for not making sheath section 32 becomes big and normal saline solution can be supplied to into disposal portion 31. In addition, in the case of drive shaft of the inner tube for shears shape type, carrying out above-mentioned insulating properties coating can also reduce and outer tube between Swept resistance.

The present invention is not limited to above-mentioned embodiment, can carry out in the range of spirit of the invention various not changing Change, change etc..

The application be advocate with April 20th, 2012 U.S. Provisional Application application numbers 61/636269 as priority The application on basis, above disclosure is incorporated in the description of the present application, claims and accompanying drawing.

Claims (5)

1. a kind of operation device, it is characterised in that have:
Disposal portion, it is used to dispose bio-tissue;
Energy production portion, it is used to provide high frequency electric to above-mentioned disposal portion;
Liquor charging pipeline, it is used to for liquid to pass out to above-mentioned bio-tissue;
Suction pipeline, it is used to attract aforesaid liquid;
Energy hole portion, it exports the high frequency output control signal for controlling the high frequency electric in above-mentioned energy production portion;
First pump drive division, it is being exported according to the output order of the above-mentioned high frequency output control signal in above-mentioned energy hole portion Aforesaid liquid, and stopping according to above-mentioned high frequency output control signal are sent during above-mentioned high frequency electric from above-mentioned liquor charging pipeline Only order, stopping sends aforesaid liquid from above-mentioned liquor charging pipeline;And
Second pump drive division, it ceases and desist order according to the above-mentioned high frequency output control signal in above-mentioned energy hole portion, from above-mentioned Time or the amount of regulation that suction pipeline attraction aforesaid liquid specifies, and in the time or above-mentioned rule for attracting above-mentioned regulation Stop attracting aforesaid liquid from above-mentioned suction pipeline after fixed amount, wherein, above-mentioned energy hole portion and above-mentioned high frequency output control The output of signal processed stops linkedly starting to drive above-mentioned second pump drive division to attract above-mentioned using above-mentioned second pump drive division Liquid, after the aforesaid liquid above-mentioned time of regulation or the amount of above-mentioned regulation is attracted using above-mentioned second pump drive division, is entered Row control stops above-mentioned second pump drive division.
2. operation device according to claim 1, it is characterised in that
The amount of the time of above-mentioned regulation or above-mentioned regulation is stored in storage part and can carry out setting change.
3. operation device according to claim 1, it is characterised in that
The amount of the time of above-mentioned regulation either above-mentioned regulation be according to the output time of above-mentioned high frequency output control signal or on State the driving time of the first pump drive division to set.
4. operation device according to claim 1, it is characterised in that
Above-mentioned energy hole portion is received to above-mentioned energy production after stopping in the output of above-mentioned high frequency output control signal When the generation of the above-mentioned high frequency electric in portion is indicated, stop above-mentioned second pump drive division.
5. operation device according to claim 1, it is characterised in that
Also there is impedance detection section, the impedance detection section is to clamping two clamping parts of above-mentioned bio-tissue in above-mentioned disposal portion Impedance between part detected,
The amount of the time of above-mentioned regulation or above-mentioned regulation according to the impedance that detects in above-mentioned impedance detection section it is different and not Together.
CN201380010521.9A 2012-04-20 2013-04-05 surgical device CN104135957B (en)

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JPWO2013157408A1 (en) 2015-12-21
CN104135957A (en) 2014-11-05

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